confused

[Caro44]

If the blood serum b12 is very high, if you have a b12 deficiency is the MMA high or low? If b12 is very high and MMA low mean there is no b12 problem?

[Foggyme Administrator]

Hi Caro44. If serum B12 is very high and your MMA is also very high, then your are likely to have a problem with B12.

If your B12 is very high and your MMA is low, then it is unlikely that your symptoms are caused by B12 deficiency.

As per your previous posts, have you been fully investigate for diabetis, thyroid issues, and other autoimmune (Sjogren's / Lupus) or neurological conditions?

These condition can cause the same or similar symptoms to B12 deficiency.

If you are 'going it alone' with the B12 injections, then please do consider going along to your GP (or primary health provider) for further investigations - especially if you have a proven small fibre neuropathy (which I think you've mentioned before - but excuse me if I'm wrong).

I really can understand how anxious this is all making you and think that if you could get some additional medical support, it will help you get to the root cause (or causes) and help you sort all this out so that you can get some treatment to help you (for instance, people here have reported some very good effects from taking pregabalin or gabapentin for the pain experienced from neuropathy).

Hope,you find some answers soon.

Take care 👍

[Caro44 in reply to Foggyme]

My serum b12 was 2000 and my MMA my Dr. told me was 128 range 0-327. So I guess B12 isn't my issue. I am sorry I took up so much of everyone's time. I do not know if I should contine supplementing with it or not. I assume not if it is that high. Correct? Thank you

[Foggyme Administrator in reply to Caro44]

Hi Caro44. Taking up time's not a problem - most here are looking for answers and it's a time consuming business - made worse when GP's know so little about B12 deficiency / PA.

The first thing about B12 is - it's not dangerous, so it won't hurt you.

The next thing is - have you ever had a blood test which showed you were either deficiency or had a very low (toward the bottom of the reference range) B12 result?

I ask this because a high level of serum B12 is not a reason to stop injections if you were ever shown to be deficient or low in B12 (high levels are simply a sign that you have been supplementing with B12). The thing that should be treated are the symptoms, not the blood levels.

The difficult thing is knowing if symptoms are due to B12 deficiency, PA, or some other condition.

If you know that you have been deficient, then it's perhaps best to continue with the injections and work out a regime that suits you. But if you have never been B12 deficient, then the answer most probably lies elsewhere.

It's quite difficult to know how best to help you as it's not quite clear what investigations you have had.

Seriously suggest that the best way to get to the bottom of all this is to get medical advice and further investigations from your GP.

There might well be an as yet unlooked for solution and I know we would all really love to hear that you'd found some answers and were beginning to feel better.

Take very good care 😀

[Caro44 in reply to Foggyme]

My friend swears that low end MMA means B12 deficiency even if the blood serum level is normal or high. I explained that you all would know best. Mine was 128 with a high of 327. Does that def not mean b12 deficiency? thanks again

[Foggyme Administrator in reply to Caro44]

Hi Caro44. Your friend is wrong. MMA goes up when there is no B12 to process - meaning you have a problem with Not enough B12.

When MMA is low it means that it is being used by the body because there is enough B12 to use it all up.

Your level at 128 (with the upper limit at 327) means that your MMA level is well below a level that would indicate a problem with B12 deficiency.

It is a mistake to assume that low MMA means low B12 - it's actually the other way round - high MMA means B12 deficiency.

The low MMA together with the absence of any low or deficiency serum B12 make it highly unlikely that you have a B12 deficiency.

So please do explore other causes for,your symptoms.

Hope this helps 👍

[Caro44 in reply to Foggyme]

What do you think of this?

BUT And serum methylmalonic acid is not accurate in cases of intestinal bacterial overgrowth, which we know is very common.

It is from chriskresser.com/what-cause...

I def. have SIBO. Thank you again

[Foggyme Administrator in reply to Caro44]

Sorry Caro44 - beyond knowing that he practices alternative medicine - no idea.

Perhaps others here will be more familiar with his work.

[fbirder in reply to Foggyme]

Oooh! Looks like Chris Kresser has moved on from acupuncture and the paleo diet to the latest fad.

[Caro44 in reply to Foggyme]

Actually i do think my b12 was low in the past. But i wasn't supplementing when I got these results. not the blood serum. With the MMA I was supplementing very occasionally with about half a vial. what do you think?

[Foggyme Administrator in reply to Caro44]

B12 results can be affected for some time after supplementing - but no way of knowing for how long 'cause individual bodies work differently (could be for months).

If you hadn't supplemented for some time prior to these results, then the serum B12 is likely correct.

Supplementing with B12 can lower MMA but no way of knowing if this happened in your case

[Caro44]

Not that I know of. The only tests I have had were high in B12. Very high so I assumed the MMA would be very high, too. Serum B12 was 1750 without supplementing B12 and 2000 with occasional supplementing. My MMA was in the lower end of the ref. range. Thank you so much for your help.

[Foggyme Administrator in reply to Caro44]

If your serum B12 was that high with no supplementation having taken place, then your GP should investigate further.

High serum B12 levels without B12 supplementation can be an indicator of other underlying medical conditions.

Ask your GP to investigate (you may need to remind him/her that your levels were that high before supplementation or they will assume that it is simply a result of the supplements - as I understand it, not so in your case).

👍👍

[Caro44 in reply to Foggyme]

Do you know what could cause it? My Dr hasn't a clue.

[Foggyme Administrator in reply to Caro44]

To be honest....cause what? Your symptoms?

Many things can cause symptoms like yours (see above and other replies).

Have you approached your GP about testing and investigations (as suggested) - other than B12?

Really think that to be sure, you need to look elsewhere - not just at B12 - only way to be sure.

👍👍

[Caro44]

Cause the b12 to be high. Never mind though, I found some. My dr. wants me to continue doing the shots. he is an alternative doctor. I spoke to him this afternoon. Praying i get some relief! I do feel that it hurts worse on the shots. Atleast further up my leg, so maybe that means my nerves are responding some!

[Foggyme Administrator in reply to Caro44]

Hi Caro44....Ah ha, I see...sorry, lost the thread for a moment.

Continuing with the B12 shots will do you no harm. However, I would strongly urge you to see a conventional medical practitioner to undergo further investigations and testing, if your alternative doctor has not explored all possibilities to account for your symptoms.

Hope you feel better soon.

[Caro44 in reply to Foggyme]

thank you

[Sleepybunny]

My reading around the subject has led me to believe that no test including b12, Active B12, homocysteine, MMA is foolproof.

info about MMA

stichtingb12tekort.nl/weten...

My understanding about MMA tests is that the results can be affected if a person is already taking B12 supplements prior to test.

b12deficiency.info/b12-test...

I am not a medic.